243 Public Health Reviews, Vol
243 Public Health Reviews, Vol. 32, No 1, 243-255 Micronutrient Defi ciency Conditions: Global Health Issues Theodore H Tulchinsky, MD, MPH1 ABSTRACT Micronutrient defi ciency conditions are widespread among 2 billion people in developing and in developed countries. These are silent epidemics of vitamin and mineral defi ciencies affecting people of all genders and ages, as well as certain risk groups. They not only cause specifi c diseases, but they act as exacerbating factors in infectious and chronic diseases, greatly impacting morbidity, mortality, and quality of life. Defi ciencies in some groups of people at special risk require supplementation, but the most effective way to meet community health needs safely is by population based approaches involving food fortifi cation. These complementary methods, along with food security, education, and monitoring, are challenges for public health and for clinical medicine. Micronutrient defi ciency conditions relate to many chronic diseases, such as osteoporosis osteomalacia, thyroid defi ciency colorectal cancer and cardiovascular diseases. Fortifi cation has a nearly century long record of success and safety, proven effective for prevention of specifi c diseases, including birth defects. They increase the severity of infectious diseases, such as measles, HIV/AIDS and tuberculosis. Understanding the pathophysiology and epidemiology of micronutrient defi ciencies, and implementing successful methods of prevention, both play a key part in the New Public Health as discussed in this section, citing the examples of folic acid, vitamin B12, and vitamin D. Key Words: micronutrient defi ciency conditions, global health, folic acid, vitamin D, vitamin B12, defi ciency INTRODUCTION Micronutrient Defi ciencies (MNDs) are of great public health and socio- economic importance worldwide.
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